Felodipine, a
dihydropyridine calcium-channel antagonist, significantly reduces systolic and diastolic blood pressure (BP) in patients with
hypertension and has been associated with beneficial hemodynamic effects in patients with
chronic stable angina pectoris or
congestive heart failure (CHF). In hypertensive patients,
felodipine does not appear to significantly affect glomerular filtration rate,
creatinine clearance,
glucose tolerance, or plasma
lipoprotein concentrations. Studies comparing
felodipine with other agents as monotherapy in mild to moderate
hypertension have demonstrated
felodipine to be at least as efficacious as
hydrochlorothiazide (
HCTZ) and
HCTZ plus
amiloride hydrochloride in combination. Comparisons of
felodipine with other agents as adjuncts to beta-blocker or
diuretic therapy have shown
felodipine to be at least as effective as
HCTZ,
propranolol hydrochloride,
prazosin hydrochloride, and
nifedipine. Evaluations of patients with
chronic stable angina are limited, and additional studies are needed before
felodipine can be recommended for the routine management of
angina pectoris. Similarly, additional studies are essential to delineate the role of
felodipine, if any, in the management of CHF. In the management of
hypertension,
felodipine 5-40 mg/d significantly reduces systolic and diastolic BP. Although some patients may be controlled throughout the entire dosing interval when
felodipine is administered bid, many patients will require more frequent dosing to obtain adequate BP control. Adverse effects associated with
felodipine are similar to those of other
dihydropyridine calcium-channel antagonists and include peripheral
edema,
headache,
dizziness,
flushing, and
fatigue. A potentially clinically important drug interaction was observed when
felodipine was administered concomitantly with
theophylline aminopropanol; significant decreases in
theophylline concentrations were noted. In summary,
felodipine appears to be safe and effective for the management of
hypertension when used alone or in combination with other
antihypertensive agents. The efficacy of
felodipine in the management of chronic
stable angina pectoris and CHF requires further investigation.